CARE and Obstetric Emergencies

I'm really excited to announce a new project Fit Pregnancy and I are taking on. We're teaming up to support CARE. Here's their "about us" statement: CARE is a leading humanitarian organization fighting global poverty. We place special focus on working alongside poor women because, equipped with the proper resources, women have the power to help whole families and entire communities escape poverty.

Why CARE? Because we do. Here's how our new adventure came about. For me, it started last spring on my first day off after working a long haul of 12-hour shifts at the hospital. We were in the middle of a mini boom, delivering baby after baby. I don't know how many births I was in on either as the labor nurse, resuscitation nurse or extra set of hands for another nurse—a whole lot of babies. We'd had a big emergency case the day before where one mother tried to hemorrhage on us. We ran her to the operating room and within minutes, safely had her baby out. We used all the tools in the toolbox to fix mom up. Her baby needed a full-on jumpstart (we call those resuscitations—where baby needs help breathing, circulating blood and, well, living). Once we'd stabilized him in the OR, Baby went off to the NICU. Mom went to a postpartum suite and by the end of the day, she was stable enough to wheel to the nursery and hold her baby. A few days later, they wheeled out the hospital doors and I presume, on to a wonderful life together.

Those shifts where we hit the ground running and don't take a deep breath until the end of our day are the kind that go fast, test all our skills and are frankly, rather exhilarating if also crazy exhausting. They're just like episodes of Grey's Anatomy or ER, except those nurses wear nicer scrubs and look like movie stars and our patients rarely wrap labor up in nice one-hour segments. Oh, and they all have better hair.

So, there I was finally on a day off. I was sitting on the couch with a cup of coffee and my laptop and clicked on the Today show for "background-music" while I answered email. And there was Christy Turlington. She caught my eye because she's the spitting image of my niece, Lisa. It's amazing how similar they are. Like twins or doppelgangers. She was talking about her recent travels as an ambassador for CARE to a mountain region in Peru; checking out hospitals and health centers participating in the FEMME project (Foundation to Enhance the Medical Management for Emergencies). CARE's objective with FEMME is improving women's access to emergency obstetric services.

This was where I was hooked. I've been involved in countless obstetric emergencies. Maybe hundreds. Some of them are freaking stressful; life and death for mom or baby and none too good for the staff's blood pressure either; and that's with all the tools, skills, technology and life saving equipment available in American hospitals. I've never, in all my years, ever had a mother die under my watch. Believe, me, that's no testament to my skills. That's a testament to how well American hospitals are equipped to deal with emergency obstetric events. We're trained, drilled, equipped, supported and ready. Only 1 out of 30,000 American women die due to a pregnancy-related crisis. In other parts of the world, it's 1 in 6 who die. One in Six.

It's our best work when we rush a bleeding mother down the hall to the OR, do a crash c-section, pump her full of blood after she's lost a ton and, while we're at it, save her baby's life. Imagine what it would be like if that same woman was a full day's walk from the closest hospital. Even if she survived the traveling, imagine if there was no doctor on-call, no blood bank, no anesthetist to make her numb for surgery. Imagine if none of the nurses at the hospital knew how to do a resuscitation on a newborn. I didn't want to imagine. I wanted to help.

I logged on to CARE.org, emailed the media-relations department and said, "Here are my skills: I'm an OB nurse and writer. What can I do?" Well, email after email, it's finally come down to this. Fit Pregnancy is committed to telling the stories of how CARE helps mothers around the world. They're going to sponsor me to travel to Peru, interview CARE members, talk to doctors, mothers, nurses and midwives and report back on the countless ways CARE has improved obstetric services. Peru's FEMME project is a huge success. They've improved emergency OB services by 50%. I get to go see why and find out how we can all do more.

I can't tell you how excited I am about this. Week after week, I get emails from women around the world with questions and I feel honored to be part of this worldwide sisterhood. Questions like Mosadinyana's. Mosadinyana is from Africa (not sure where exactly but I think Botswana) and here's her question: Is it necessary to have a tummy massage every month? Apparently the benefits are that the massage (which is usually done by old women) helps rotate the baby's head to face down. How true is it?

My answer: Necessary? Well, maybe not absolutely necessary but there may be some benefits to this extremely cool practice. I love that older women carry this tradition to younger women as a hands-on ritual. While there might not be any scientific studies to support abdominal massage as a way of preventing babies from turning breech, there may be experiential evidence. Women have been delivering babies for thousands of years and a lot of what we do today is a direct result of all that hands-on wisdom.

It's not recommended to have abdominal massage at all during the first trimester due to the chance of disrupting the placenta and irritating the uterus. During the second and third trimesters, massage can reduce stress, muscle aches, back pain and anxiety. Go for a side-lying position and be gentle on the tummy. When we have a breech baby at the hospital, we often try an advanced, medically supervised, massage technique called external version where the doctor uses ultrasound to determine where the baby's head is. Then he/she pushes down on the butt and head in just the right way to turn him/her. We do fetal heart monitoring to make sure baby is safe. I don't recommend anyone try this at home. Leave this to the pros. It is, however, pretty successful.

So, is it necessary? No. Helpful? Maybe. Cool? Absolutely. Let me ask you this, Mosadinyana? Are you ticklish? Is there another reason why you don't want this done? If so, you've got my official permission to bow out. You don't have to get abdominal massage if you don't want to.

I'll keep you all posted about my adventures with CARE. I'm honored they'll let me be involved and thrilled that Fit Pregnancy will make my participation possible. Thank you both for this wonderful opportunity. And Christy, you totally inspired me and I can't wait to walk in your footsteps in Peru. By the way, you do look amazingly like my niece, Lisa.

This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.